Too far, too fast: The King's Fund verdict on coalition health reforms

The King's Fund has called on ministers to reconsider the speed and scale of new health reforms if they are to deliver benefits to patients and improve NHS performance.

In its response to the government's health White Paper, the Fund supports the need for reform but questions the need to embark on a fundamental reorganisation of the NHS when evidence shows that health outcomes and public satisfaction have improved in recent years. It argues that the scale and speed of reform will distract attention from finding the efficiency savings needed to maintain quality and avoid cutting services, as the NHS faces the most significant financial challenge in its history.

While it supports many of the government's proposals - including giving GPs a stronger role in commissioning services, extending choice for patients and enhancing the role of local authorities in the health system - the Fund calls on ministers to think again about their plans for implementing the reforms. It identifies a number of areas where it believes a more measured approach to implementation could ensure the reforms deliver real benefits including:

  • moving quickly to work with GPs who are ready to embrace GP commissioning, giving them 'real' budgets for some services as soon as possible and using their experience to inform the national roll-out, rather than imposing the GP consortia model in all areas of the country by 2013
  • streamlining NHS structures over time as new GP consortia get up to speed instead of abolishing primary care trusts and strategic health authorities in 2013
  • balancing the need for a regulatory framework that promotes competition to drive up quality, while encouraging collaboration where services should be co-ordinated - for example, in meeting the needs of older people and those with long-term conditions.

Professor Chris Ham, Chief Executive of The King's Fund said:

'There are areas where NHS performance needs to improve and we support many of the proposals in the White Paper. But we question the need to embark on such a fundamental reorganisation as the NHS faces up to the biggest financial challenge in its history.

'I hope ministers will think again about the plans for implementing these proposals. This does not mean putting the brakes on across the board. In some areas, they could in fact move more quickly by beginning to test out and evaluate how key elements of the reforms will work in practice.'

Read our response to the individual consultations

Notes to editors: 

  1. For further information or interviews, please contact The King’s Fund press and public affairs office on 020 7307 2585, 020 7307 2632 or 020 7307 2581 or on the out-of-hours mobile 07584146035.  An ISDN line is available for interviews on 020 7637 0185.
  2. The King’s Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.